Antiseptic rinses in periodontitis therapy: EFP 2026 recommendations and reconsideration of adjunctive tools

At a press briefing held as part of the International Symposium on Dental Hygiene (ISDH) in Milan, experts discussed two new professional reports containing practical recommendations for the prevention and treatment of periodontal diseases. The central idea of both publications comes down to one thing: liquid antiseptic mouthrinses work only together with mechanical hygiene, not instead of it.

Two independent positions — one scientific direction

Specialists discussed two reports: the white paper by the American Dental Hygienists’ Association (ADHA) “Rethinking the Management and Prevention of Periodontitis” and the initiative “Principles of Oral Health,” supported by the Spanish Association of Periodontology and Osseointegration. Although the publications were developed in different professional contexts, their conclusions coincide and are based on a single evidence base — including recommendations from the European Federation of Periodontology and the American Academy of Periodontology.

Indications for adjunctive use of antiseptics

Both documents define clear indications for adjunctive rinsing. Local factors include crowded teeth, complex prosthetic structures, orthodontic appliances, and implant-supported dentures. Patient-associated factors include the presence of fine motor impairment and physical weakness. Systemic conditions encompass diabetes mellitus and other diseases that increase the risk of periodontitis.

With persistent gingival inflammation and difficulty achieving effective mechanical control of biofilm, antiseptic rinsing may be considered as an adjunctive tool in comprehensive periodontitis therapy.

Evidence base for effectiveness

In the ADHA white paper, a randomized clinical trial is cited in which a three-step home hygiene regimen (toothbrushing, flossing, and rinsing with a solution of four essential oils) showed significantly greater reduction in supragingival plaque, gingivitis, and gingival bleeding compared to toothbrushing alone. However, the results are interpreted as an effect of the complete regimen rather than isolated use of rinsing, which confirms the adjunctive rather than independent nature of antiseptics.

Individualization and reassessment as a key principle

Both publications emphasize the critical importance of an individualized approach when prescribing antiseptic agents. Recommendations should consider the clinical indication, evidence for the specific formulation, potential side effects, and require regular reassessment during supportive periodontal therapy. Mechanical hygiene remains the foundation of home care, while rinsing serves as an adjunct for specific clinical situations requiring additional anti-inflammatory support.

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Original publication